The father of Zhang, who is in his seventies, is particularly happy this New Year, several sons working in the field have rushed back with their wives and children, the family reunion for the old father’s 70th birthday, and it is a joyous occasion. Father Zhang is happy to be unable to close his mouth, busy in and out every day. The first thing you need to do is to get a good idea of what you are getting into. With the aging of the global population, the age of onset of shingles is gradually shifting to the elderly. Both herpes zoster and chickenpox are caused by the varicella-zoster virus. After initial infection with this virus, it enters the body through the respiratory mucosa and then spreads through the bloodstream, manifesting clinically as chickenpox or an insidious infection, and the majority of those presenting with chickenpox are children. Since the virus is neurophilic, it can be latent in the sensory ganglia of the posterior roots of the spinal cord or brain nerves for years or even decades. Once these infected people have colds and fevers, exertion, trauma, chronic wasting diseases (such as diabetes), tumors, etc., or when they take hormones and immunosuppressive drugs for a long time, they can activate the varicella-zoster virus that is latent in their bodies due to a decrease in body resistance and weakened immune function. The offspring of the virus reproduction will return to the skin or mucous membrane surface along the sensory nerves and finally cause herpes zoster at that place. In the elderly, the immunity of the body is reduced, and the virus latent in the ganglion is more likely to be activated and develop under the effect of various triggering stimuli. There are various sites and manifestations of the lesion depending on the extent and location of viral invasion of the nerve. Intercostal herpes zoster: The onset is often preceded by mild fever, fatigue, general malaise and poor appetite, and pain at the skin of the chest and back. Later, erythema and clusters of corn- to green-bean-sized herpes will appear on the painful skin one after another. These herpes are often arranged in bands along the distribution of the intercostal nerves and are often located on one side of the body, never exceeding the midline of the trunk. The blisters are absorbed, dry and crusted over after a few days, and the entire course of the disease lasts about 3 weeks. Facial herpes zoster: If the ophthalmic branch of the trigeminal nerve is damaged, there is often an inverted triangular shaped herpes on the forehead with severe symptoms and pain, which can involve the cornea and the eye. Herpes zoster of the ear: The virus invades the geniculate ganglion of the facial nerve in the elderly, causing herpes, ear pain and facial paralysis in the external ear canal and auricle on one side. In a few elderly people, hearing loss or nausea, vomiting, vertigo and nystagmus may occur because the auditory nerve is affected. Herpes zoster in the neck: When the cervical plexus nerve is attacked by the virus, herpes can appear at the root of the neck and upper clavicle, and sometimes up to the occiput, collar and lower auricle. In young and middle-aged people, the pain disappears when the herpes zoster heals. Even after herpes zoster is healed, 10% to 50% of the elderly still have pulling or cutting neuralgia, especially the older they are, the later they seek medical attention, and the more likely they are to have persistent “postherpetic neuralgia” that can last for months, six months, or even longer. This is mainly due to the poor nerve repair ability of the elderly. Although there is no specific treatment for post-herpetic neuralgia in the elderly, pain can be relieved by oral and topical medications, local physical therapy such as helium-neon laser, ultraviolet light therapy and microwave, and in severe cases, nerve closure.